Natalie Allcott1, Lisette Dunham2, David Levy3, Jacquelyn Carr4, Karyn Stitzenberg5. 1. Campbell University School of Osteopathic Medicine, USA. 2. Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. 3. Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA. 4. Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. 5. Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. Electronic address: karyn_stitzenberg@med.unc.edu.
Abstract
BACKGROUND: The costs of cancer care in the US continue to increase and may have serious consequences for patients. We hypothesize that even cancer patients treated with curative-intent surgery alone experience substantial financial burden. METHODS: A questionnaire was administered to adult cancer patients who were treated with curative-intent surgery. Survey items included a validated instrument for measuring financial toxicity, the COST score. Demographic variables and survey responses were examined using Chi-square and Fisher exact tests. A multivariate general linear model was performed to examine the relationship between age and COST score. RESULTS: COST scores varied widely. 30% of respondents had a COST score of ≤24 (high burden). Younger participants reported more financial burden (p = 0.008). Respondents reported that financial factors influenced their decisions regarding surgery (14%) and caused them to skip recommended care (4.7%). Cancer care influenced overall financial health (38%) and contributed to medical debt (26%). CONCLUSION: Curative-intent cancer care places a substantial portion of patients at risk for financial toxicity even when they don't require chemotherapy. Interventions should not be limited to patients receiving chemotherapy.
BACKGROUND: The costs of cancer care in the US continue to increase and may have serious consequences for patients. We hypothesize that even cancerpatients treated with curative-intent surgery alone experience substantial financial burden. METHODS: A questionnaire was administered to adult cancerpatients who were treated with curative-intent surgery. Survey items included a validated instrument for measuring financial toxicity, the COST score. Demographic variables and survey responses were examined using Chi-square and Fisher exact tests. A multivariate general linear model was performed to examine the relationship between age and COST score. RESULTS: COST scores varied widely. 30% of respondents had a COST score of ≤24 (high burden). Younger participants reported more financial burden (p = 0.008). Respondents reported that financial factors influenced their decisions regarding surgery (14%) and caused them to skip recommended care (4.7%). Cancer care influenced overall financial health (38%) and contributed to medical debt (26%). CONCLUSION: Curative-intent cancer care places a substantial portion of patients at risk for financial toxicity even when they don't require chemotherapy. Interventions should not be limited to patients receiving chemotherapy.
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